Special Care Gold


Unique Plan Specially designed policy for the persons with a disabilities as per The Rights of Persons with Disabilities Act, 2016 Or / and for individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017.
Policy Type This policy provides benefits only on an individual basis.
Policy Term The policy can be taken for a term of 1 year.
Sum Insured The Sum Insured options under this policy are Rs.4,00,000/- and Rs. 5,00,000/-.


Disability Cover The coverage under this policy is available for persons with the following disability/disabilities as defined under the Act and any subsequent additions/modifications to the list in the Act. Disability for the purpose of this policy means a person with 40% or more of a specified disability as Certified by the Certifying authority as per the Disability Act 2016. 1. Blindness 2. Muscular Dystrophy 3. Low vision 4. Chronic Neurological conditions 5. Leprosy Cured persons 6. Specific Learning Disabilities 7. Hearing Impairment (deaf and hard of hearing) 8. Multiple Sclerosis 9. Locomotor Disability 10. Speech and Language disability 11. Dwarfism 12. Thalassemia 13. Intellectual Disability 14. Haemophilia 15. Mental Illness 16. Sickle Cell Disease 17. Autism spectrum disorder 18. Multiple Disabilities including deaf/ blindness 19. Cerebral Palsy 20. Acid Attack victim 21. Parkinson’s disease
HIV Cover This policy is available for individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017. Individuals diagnosed as HIV/AIDS by a duly qualified Medical Practitioner with a CD4 count above 350 will only be eligible for cover under this policy.

Disability Cover

The coverage under this policy is available for persons with the following disability/disabilities as defined under the Act and any subsequent additions/modifications to the list in the Act. Disability for the purpose of this policy means a person with 40% or more of a specified disability as Certified by the Certifying authority as per the Disability Act 2016. 1. Blindness 2. Muscular Dystrophy 3. Low vision 4. Chronic Neurological conditions 5. Leprosy Cured persons 6. Specific Learning Disabilities 7. Hearing Impairment (deaf and hard of hearing) 8. Multiple Sclerosis 9. Locomotor Disability 10. Speech and Language disability 11. Dwarfism 12. Thalassemia 13. Intellectual Disability 14. Haemophilia 15. Mental Illness 16. Sickle Cell Disease 17. Autism spectrum disorder 18. Multiple Disabilities including deaf/ blindness 19. Cerebral Palsy 20. Acid Attack victim 21. Parkinson’s disease

HIV Cover

This policy is available for individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017. Individuals diagnosed as HIV/AIDS by a duly qualified Medical Practitioner with a CD4 count above 350 will only be eligible for cover under this policy.


In-Patient Hospitalisation Hospitalisation expenses incurred for more than 24 hours of hospitalisation are covered.
Room Rent Room, boarding and nursing expenses all inclusive as provided by the Hospital/Nursing Home are covered up to 1% of the Sum Insured per day.
ICU Charges Intensive Care Unit (ICU) charges/Intensive Cardiac Care Unit (ICCU) charges all inclusive as provided by the Hospital/Nursing home are covered up to a maximum of 2% of the Sum Insured per day.
Pre-Hospitalisation In addition to in-patient hospitalisation, the medical expenses incurred up to 30 days before the date of admission to the hospital are also covered.
Post-Hospitalisation Post-hospitalisation medical expenses including consultation fees, diagnostic charges, medicines and drugs as recommended by the Hospital / Medical Practitioner are covered up to 60 days from the date of discharge from the hospital.
Emergency Road Ambulance Ambulance charges are covered up to the maximum of Rs. 2000/- per hospitalisation.
Day Care Procedures Medical treatments and / or surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.
Cataract Treatment Expenses incurred for Cataract treatment are covered up to Rs. 40,000/- per eye in one policy year.
Co-payment Each and every claim under this policy shall be subject to a Co-payment of 20% applicable to the claim amount admissible and payable as per the terms and conditions of the policy.
Waiver of Co-payment Waiver of co-payment is available on payment of additional premium as per terms & conditions.


Lumpsum Coverage for HIV/AIDS In case the CD4 count of the insured is/goes below 150, then the Company will pay 100% of the Sum Insured or the balance Sum Insured available under the policy, whichever is lower, as a lumpsum amount to the insured. This payment will trigger after a waiting period of 90 days from the commencement date of the policy. Note: The claim mentioned above shall be payable once in the lifetime of the insured person and shall not be necessarily linked to an in-patient hospitalisation claim made under the policy.

Lumpsum Coverage for HIV/AIDS

In case the CD4 count of the insured is/goes below 150, then the Company will pay 100% of the Sum Insured or the balance Sum Insured available under the policy, whichever is lower, as a lumpsum amount to the insured. This payment will trigger after a waiting period of 90 days from the commencement date of the policy. Note: The claim mentioned above shall be payable once in the lifetime of the insured person and shall not be necessarily linked to an in-patient hospitalisation claim made under the policy.


Pre-existing Diseases I) Applicable for Diseases other than Disability/HIV/AIDS: The expenses related to the treatment of pre-existing diseases and their direct complications are covered after a waiting period of 36 months of continuous coverage after the date of inception of the first policy with the insurer. II) Applicable for HIV/AIDS: The expenses related to the treatment of HIV/AIDS and its direct complications are covered after 90 days of continuous coverage from the date of inception of the first policy with the insurer. III) Applicable for Disability: The expenses related to the treatment of pre-existing disability and its direct complications are covered after 24 months of continuous coverage after the date of inception of the first policy with the insurer.
Specific Disease The expenses related to the treatment of listed conditions, surgeries and treatments are covered after a waiting period of 24 months of continuous coverage after the date of inception of the first policy with the insurer.
Initial Waiting Period The expenses related to the treatment of any illness within 30 days from the first policy commencement date are excluded except for claims arising due to an accident.

Please refer to the Policy Documents to know the policy details and Terms & Conditions.